Medicare Payment and Value of Care Analysis by State 2013-2016

Using publicly available data from Medicare, I analyzed the payment and value of care data for Heart Attack, Heart Failure, Hip/Knee Replacement, and Pneumonia. The data I downloaded were intended for public use and it was downloaded from the following link on 6/20/2018. https://data.medicare.gov/data/hospital-compare. The data was collected from 2013 through 2016 and it collected the payment data for each hospital. If you would like to see my analysis in detail, you may click here to Download my analysis in Excel spreadsheet. The file works best in Microsoft Excel 2016 version.

According to the analysis, average medicare payment were higher in New Jersey, Nevada, Florida, Connecticut, Massachusetts, Rhode Island, and Texas. In contrast, the payments were lower in Alaska, Montana, New Mexico, Oregon, Wyoming, North Dakota, and South Dakota.

The value of care (measured by better mortality and complications) was better in Delaware, Massachusetts, DC, Rhode Island, Connecticut, New Jersey, and California, but lower in Arkansas, Nevada, Alabama, Tennessee, And Mississippi.

The value of care per payment was better in Alaska, Montana, New Mexico, South Dakota, Oregon, North Dakota, and Minnesota. However, the value of care per payment was lower in Nevada, New Jersey, Florida, Texas, Connecticut, and Pennsylvania.

Graph-1 Medicare Average Payment for Heart Attack, Heart Failure, Hip/Knee Replacement, and Pneumonia (2013-2016)

401K Plan for 2018 Pharmacy Graduates

Graduating from pharmacy school, you might want to plan your savings right away even though you may have lots of student loans to pay off. The earlier you save, the better since the compound interest will kick in earlier, which will make a big impact on your savings in the end. In the below, there are example graph and table of a sample 401K plan if you put in 8% of our yearly salary with 7.5% compound interest. You may make your own 401K plan with the excel spreadsheet I developed and attached on this link: Download 401K Plan Spreadsheet Here

Graph-1 Example of 401K Balance when you put 8% of your yearly salary with starting salary of $120,000 at age 26

You Could Save Hundreds of Dollars on Your Co-Pays

If you take any brand name prescription medication without generic alternative and your copay is expensive, you could easily save money by simply bringing a coupon or copay card to your pharmacist. This could save you hundreds of dollars in some cases depending on your insurance plan, copay, and/or medication. The coupons for the most brand name medications are usually provided by their manufacturer and they can be easily found on their website. However, in order to use the copay card, the drug price should go through your third party private insurance first. The copay card will most likely not work if you have government sponsored insurance or have no insurance. Below are few links to the coupon websites for common brand-name medications.

Advair Coupon
Eliquis Coupon
Humalog Coupon
Humira Coupon
Januvia or Janumet coupon
Lantus Coupon
Lyrica Coupon
Novolog Coupon
Xarelto Coupon
Xifaxan Coupon

Comparison of Top 10 Global Prescription Sales Between 2006 and 2016

Treatments for autoimmune diseases and certain cancers were sold more than other medications in 2016. This is a big difference from the 2006 data when the top medication was Lipitor, a treatment for hypercholesterolemia. In 2006, the pharmaceutical sales were focused on cardiovascular, depression, and GERD. In contrast, autoimmune diseases and cancer treatments are the best selling drugs in 2016. Since the cardiovascular drugs and antidepressants from 2006 have now become mostly generic and the treatment regimens are optimized, the pharmaceutical companies are focusing on finding treatments for autoimmune diseases and cancer. 

I believe that in future once the autoimmune disease treatments become generic and treatment regimens are optimized, the pharmaceutical companies will focus more into PD-1 drugs such as Opdivo (Bristol-Myers Squibb) and Keytruda (Merck) and PDL-1 drugs such as Bavencio (Merck and Pfizer) and Tecentriq (Genentech). These drugs are cutting-edge research where it uses body's own immune system to attack the cancer cells. PD-1 and PDL-1 drugs are safer in terms of side effects than traditional chemotherapy because PD-1 and PDL-1 drugs target the cancer cells rather than attacking both normal and cancer cells like the traditional chemotherapy drugs. With ground-breaking researches, I hope that cancer will become treatable disease rather than terminal disease in the near future. 

Table-1 Top 10 Global Prescription medication sales, indication, and company (2016) (1)

Prediction on the Number of Pharmacists in US

According to the analysis, the number of pharmacists are growing by 6,521 annually. Currently (2017), there are 0.95 US pharmacists per 1000 US population. However, the number of pharmacists is expected to grow to be 1 pharmacists per 1000 population by year 2021. WHO recommends at least 1 pharmacist per 1000 population. According to the prediction analysis using simple regression, the number of pharmacists will grow to be 384,421 by year 2028, exceeding 1.08 pharmacists per 1000 population. Unless the number of prescriptions increases more than the number of population, pharmacists will have to find other sources of income than just traditional pharmacy practice. Hope pharmacists will be able to attain the healthcare provider status and be able to practice in other areas of healthcare. 

Graph-1 Growth of the Number of US Pharmacists